Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview.

33 Although this reduction in events in the diabetic subgroup alone did not quite reach statistical significance, the point estimate of benefit was greater among diabetics than nondiabetics.

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There was a nonsignificant trend to increased bleeding in the quintile with the greatest platelet response. 39 In a randomized trial comparing proceeding to PCI after 600 mg clopidogrel load vs one or more reloads if platelet response was subtherapeutic as measured by the VASP index, Bonello et al demonstrated a lower clinical event rate with platelet function assay guided clopidogrel therapy. 40 The GRAVITAS trial failed to show a clinically significant benefit to increasing the maintenance dose of clopidogrel to 150 mg daily in low responders to the loading dose as measured by the VerifyNow ® assay.

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